Ryan Scharer
May 15, 2020, 4 min read

As the country starts to reopen and stay-at-home orders relax, states nationwide are now allowing hospitals to return to serving the needs of non-COVID-19 patients on a broader scale.

This means elective surgeries are back.

What does the shift indicate? At the very least, some cautiously optimistic rays of hope can be seen coming from the end of what has been a very dark tunnel. On multiple levels for all parties — hospitals, providers and patients — the news of reopening elective surgeries is reason enough to exhale a sigh of relief. But it will take additional financial support for hospitals, coupled with patient trust, to execute getting back to the business of surgeries on a human and health and safety level.

Hospitals and governors around the country are expressing assurances and determination to make it work. “As anyone waiting for an elective surgery knows, ‘non-urgent’ does not mean ‘minor,’” said Gov. Kate Brown of Oregon, according to the Governor’s formal statement on the framework of the lifting order for non-urgent procedures. Oregon state hospitals resumed their elective surgery business on May 1st. “This is incredibly important medical care that we would not have told providers to delay if the threat of COVID-19 had not made it necessary.”

Oregon is not alone. Florida hospitals, outpatient centers and doctors’ offices put plans in place to reopen for elective surgeries and other procedures when the governor’s executive order banning those procedures expired on May 8th, reports the Sun Sentinel. In Louisiana, at the end of April, Gov. John Bell Edwards issued a statement saying that doctors would be able to perform treatments or surgeries to help patients avoid further harm from underlying conditions or diseases and for time sensitive conditions. Suspending or not suspending nonessential surgeries has not only meant weighing the severity of a patient’s condition, but also the availability of beds, PPE and staffing.

Once medical facilities do reopen, the new issue to wade though is the serious backlog of cases. Now that postponed surgeries are being rescheduled on a case-by-case basis, questions come up on a case-by-case basis, including whether a surgery can be further delayed safely for an extended period of time.

More Financial Help

Hospitals and healthcare systems have been facing extremes, going from serving their communities all out with elective surgeries, all kinds of emergencies and non-essential procedures day in and day out, to being focused on the surge of COVID-19, 24/7. The result: Medical facilities nationwide were hit with financial losses. This struggle is still real for so many facilities that are the mainstays of our communities nationwide, even as elective surgeries resume. It looks as if another stimulus is up for debate now that would include help for hospitals and providers to stay open and keep pushing forward. As of May 12th, the new proposal is a $3 trillion relief package introduced by the House of Representatives, which includes $100 billion in grants for hospitals and medical providers, reports The Hill.

“This is incredibly important medical care that we would not have told providers to delay if the threat of COVID-19 had not made it necessary.”

Communicating our New Normal

The medical community continues to maintain vigilance. Under specific safety procedures and guidelines, states are expected to meet certain benchmarks known as “gating criteria” for preparedness before resuming elective procedures, based on recommendations from federal health officials.

Some states that have already begun offering non-COVID-19 patients access to elective surgery and other procedures, have done so based on fulfillment of the Centers for Medicare & Medicaid Services (CMS) protocols. These protocols are intended to make sure systems are in place for reopening so that facilities can open and stay open, and do so in a very measured way, according to a CMS statement. CMS offers Phase I recommendations for how to reopen and allow facilities to provide for individuals needing non-emergent, non-COVID-19 care.

Cancer and Other Critical Treatments

Patients who were originally scheduled for critical cancer surgeries in February faced added anxiety when they were put on hold, along with a range of other patients in need of procedures, such as organ transplants. Serious health issues that demand medical attention have not stopped because of this pandemic. A challenge for the medical community is the fact that more than 600,000 people are receiving chemotherapy, according to the Centers for Disease Control and Prevention (CDC). And, more than 1.8 million new cancer cases are expected to be diagnosed in 2020, reports the American Cancer Society.

Patients have plenty of “asks” during this time, reports the American College of Surgeons. “Surgery patients may have myriad questions and concerns regarding the ramp-up period. Clear messaging and communication will be paramount.” Potential messaging-communication topics for hospitals and providers include:

  • Procedure prioritization
  • COVID-19 testing policies for patients
  • COVID-19 counseling
  • Safety for patients receiving care within the healthcare system, facilities & healthcare workers
  • PPE use
  • Patient family/visitor guidelines

“Local Resumption of Elective Surgery Guidance” from the American College of Surgeons provides a set of principles and issues to help local facilities plan for resumption of elective surgical care.

Planning for Now and Beyond

Transparency throughout this health crisis has been critical not only for our clients, but also for Hayes. My conversations with our clients and providers who work for them, is proof of that. I have spent time speaking frankly about the unprecedented landscape we are all living in. For hospitals that are pressed to make tough decisions on a human and financial level, the big picture reality is a heavy load. For many institutions, back surgeries and heart procedures provided a financial stream of revenue that was critical to staying open, reports the New York Times. “The majority of the nation’s hospitals are nonprofit, but they still need a steady roster of patients to survive.”

“Surgery patients may have myriad questions and concerns regarding the ramp-up period. Clear messaging and communication will be paramount.”

Without a doubt, having elective surgeries back on the schedule is positive progress. Now and beyond COVID-19, it is our job at Hayes to work with hospitals in partnership to ensure facilities are adequately staffed to handle patient load, elective surgeries and other procedures. And now, with elective surgeries resuming in upwards of 40 states, we will continue to do our share by connecting physicians who are looking for opportunities at hospitals in need of staff. 

By Ryan Scharer

Ryan Scharer is a co-founder of Hayes Locums, an award-winning physician and advanced practitioner staffing company founded on a commitment to advance the ability to provide exceptional patient care throughout the country. His background, which is rooted in sales for the medical industry, is critical to his role as COO. Ryan leads sales and guides the development of the Hayes Locums team of staffing consultants.

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